Reconstruction of complicated defect after ablation of superficial cranial malignant tumor with latissimus dorsi musculocutaneous flap

Abstract

Objective To deal with complicated defect 'after ablation of scalp malignant tumor, especially in patients with cranium or dura defect. Method Seventeen consecutive scalp reconstructions with free latissimus dorsi musculocutaneous flap after large tumors ablation were reviewed. Results The scalp defects varied from 15 cm × 15 cm to 20 cm ×25 cm. The cranium defect varied from 5 cm ×5 em to 14 cm× 14 cm. There were seven patients with dura defect. The dura defects varied from 5 cm ×5 cm to 10 cm ×9 cm. The areas of latissimus dorsi musculocutaneous flap varied from 19 cm × 20 cm to 30 cm× 25cm. All flaps survived intact. The defects healed primarily expect one infection under the flap. There were nine patients undergone adjacent radiotherapy. No cranioplasty was needed. Follow up time was from six months to twenty-five months (mean 17 months). There were four local recurrences and one metastasis on lung. Twelve patients survived without tumor. Conchusions The latissimus dorsi musculocutaneous flap is an optimal choice for reconstruction of extensive defect after tumor ablation. Key words: Head and neck neoplasms; Reconstruction surgical procedures; Surgical flaps